DELAYED PRIMARY CLOSURE AFTER FASCIOTOMY: A LARGE DEFECT CASE REPORT
Main Article Content
Abstract
Patients usually have large defects after fasciotomy of the extremities. By far, there are two main treatments for this defect: skin graft and delayed primary closure. Surgeons need to evaluate the characteristics of defect and patients’s condition before indicating a delayed primary closure method. We present a case of 42 year old male patient, with traumatic brain injury and hypertension history. At the left thigh, there was a 30x7 cm defect. Medial and lateral calf defects were 24x8 and 25x6 cm respectively. Nylon suture and plastic buttons were used to design a traction system. Patient underwent 2 surgeries in 14 days. The results were excellent at 6-months follow-up. Conclusion: Delayed primary closure after fasciotomy has several advantages: simple, economical and requires a short learning curve. However, appropriate patient seletion based on patient’s overall condition and defect width/circumference ratio are essential for optimal results.
Article Details
Keywords
fasciotomy, continuous traction, delayed primary closure
References
2. Sraj S, Henderson JT, Bramer M, Gelman J. Principles of Fasciotomy Closure After Compartment Syndrome Release. J Am Acad Orthop Surg. 2022;30(18):879-887. doi:10.5435/ JAAOS-D-21-01046
3. Yoo JJ, Fullerton N, Hui-Chou HG. Continuous External Tissue Expansion Closure Technique for Management of Forearm Compartment Syndrome Releases and Simple Upper-Extremity Wounds. J Hand Surg. 2021;46(7):630.e1-630.e9. doi:10. 1016/j.jhsa.2021.01.008
4. Johnson LS, Chaar M, Ball CG, et al. Management of extremity fasciotomy sites prospective randomized evaluation of two techniques. Am J Surg. 2018;216(4):736-739. doi:10.1016/j.amjsurg.2018.07.033
5. Harris I. Gradual closure of fasciotomy wounds using a vessel loop shoelace. Injury. 1993;24(8): 565-566. doi:10.1016/0020-1383(93)90040-D
6. Taylor RC, Reitsma BJ, Sarazin S, Bell MG. Early results using a dynamic method for delayed primary closure of fasciotomy wounds. J Am Coll Surg. 2003;197(5):872-878. doi:10.1016/S1072-7515(03)00646-X
7. Matt SE, Johnson LS, Shupp JW, Kheirbek T, Sava JA. Management of Fasciotomy Wounds-Does the Dressing Matter? Am Surg. 2011; 77(12): 1656-1660. doi:10.1177/ 000313481107701238
8. Kakagia D, Karadimas EJ, Drosos G, Ververidis A, Trypsiannis G, Verettas D. Wound closure of leg fasciotomy: Comparison of vacuum-assisted closure versus shoelace technique. A randomised study. Injury. 2014; 45(5):890-893. doi:10.1016/j.injury.2012.02.002